Provider Demographics
NPI:1093021941
Name:ZWICKER, THOMAS J (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:ZWICKER
Suffix:
Gender:M
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WOODLAWN ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1337
Mailing Address - Country:US
Mailing Address - Phone:203-901-0646
Mailing Address - Fax:475-227-2242
Practice Address - Street 1:34 WOODLAWN ST
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-1337
Practice Address - Country:US
Practice Address - Phone:203-901-0646
Practice Address - Fax:475-227-2242
Is Sole Proprietor?:No
Enumeration Date:2010-08-28
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-7036103K00000X
NY000162103K00000X
CT299103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst